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The Miracle Hair Transplant Technique – Pt 1

  • Thread starter Hair Restoration Europe
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Hair Restoration Europe

Hair Restoration Europe

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#1
FUE is now a long-established hair transplant technique but overtime there has been a growing tendency by some to want to dumb down the fact FUE is a surgical procedure and or aspects and consequences of the procedure assuming to play down the medical aspects or make it appear more appealing and simpler to perform.

Three random quotes from three websites just pulled off a search, it took 6 clicks to find three quotes

1. €œThe hair line is natural-looking (no linear scar). €
2. €œFUE €“Follicular Unit Extraction (FUE) is a NO Stitch, NO Scar technique €
3. €œFUE is a minimally invasive procedure that leaves almost no scarring. €

The problem with these quotes?

1. There is no correlation between the hairline looking natural and not having a linear scar
2. It maybe no stitch but it is not a €œno scar technique €
3. €œalmost no scarring € is incorrect, every punch made will leave a scar

FUE uses a cylindrical instrument to punch around the outside of a follicular unit (FU),it is then extracted to leave a small open wound initially. The wound heals superficially with a scab like any cut on the body would as part of the healing process. Overtime the wounds heal and the skin pigment settle, this can vary dependent on the application of the punch and the natural skin healing characteristics.

A scar is a mark left on the skin after a wound has healed, every wound will leave a scar, every punch made into the skin will leave a scar, the size of the scar can depend on the punch and technique and skin characteristics.

How visible will the scarring be?

Hair length can be a large factor of course because with a little hair length the coverage hides the scalp and so hides any scarring. The shorter the hair is cut the more likely the scarring will be visible.

The skin healing and the harvesting pattern can play a role then in how visible or obvious the scarring is, along with the number of follicular units removed. The tighter the extraction pattern is going to remove more FU in a smaller area leaving larger or closer situated hair-less areas, scars. Therefore, the more grafts the more scarring, the tighter the extraction pattern and the chance of it being more visible. 1500 grafts can be spread around the donor from side to side and pro rata with an educated pattern of extraction only make a small change to the overall average hair density around the donor. Double the extraction, 3000 FU, and the pattern becomes tighter and harder to manage not over harvesting areas.

This does not take into consideration any miniaturisation of hair in the donor or any transection caused when punching or extracting the FU ´s.

The skin and hair characteristics, lighter skin complexion against darker hair colour, the contrast is going to be higher than light skin complexion and blonde hair colour so making the punch marks blend more with the surrounding skin. On a side note but illustrating the point, the high contrast is actually used with the scalp pigment treatment, the contrast of the pigment gives the look of hair, and ironically whereas a low contrast helps with a hair transplant a high contrast helps with scalp pigment treatment.



 
bullitnut

bullitnut

4 awesome repairs with SMG
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#2
Great post.....the hairline is natural looking (no linear scar) comment is so far stupid it's almost ludicrous;;D
What tends to be the case too is that the clinics claiming to leave no scarring actually cause the worst punch hole scars....go figure)(_::
Good to read an honest account of what the FUE technique actually does. If more clinics were honest and more transparent it would be easier to weed out the ethical ones from the cowboys.
Thanks for sharing;)
 
Hair Restoration Europe

Hair Restoration Europe

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#3
bullitnut wrote:
Great post.....the hairline is natural looking (no linear scar) comment is so far stupid it's almost ludicrous;;D
What tends to be the case too is that the clinics claiming to leave no scarring actually cause the worst punch hole scars....go figure)(_::
Good to read an honest account of what the FUE technique actually does. If more clinics were honest and more transparent it would be easier to weed out the ethical ones from the cowboys.
Thanks for sharing;)
Thankyou bullitnut, the aim is to just be open about the procedure, sometimes talking with people they are surprised to hear the donor hair once taken is never growing back. This maybe left to interpretation rather than actually being told this, hopefully, but either way not good obviously as it shows a lack of awareness what they are getting into and this is not helped if we do not do all we can to ensure well educated candidates.
 
T

Tilleylamp

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#4
There are many variants to the name FUE these days.
 
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Bigmac

Bigmac

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#5
Nice read pointing out straight facts. I €™ll look forward to reading part 2.
 
Hair Restoration Europe

Hair Restoration Europe

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#6
Bigmac wrote:
Nice read pointing out straight facts. I €™ll look forward to reading part 2.
Thanks Bigmac, here is part 2 on the amount taken in one procedure

One of the largest issues with FUE was always that FUT in good hands and the right candidate could reach 4000 odd grafts in a one-day procedure whereas FUE, especially in the early days would struggle to reach 500 but later around 1500 and 3000 over a two-day procedure.

Because the extraction process is so different between the two techniques it takes a very different point of view what can be taken and how. With FUE the skin surface area does not change but the hair density in the donor zone does. Basically, the more that is taken the less is left.

Trying to create a random but thought out extraction pattern is not easy as our brain is wired to patterns. Large FUE sessions, like 4000 grafts puts a lot of pressure on the person punching to spread the punches enough not to take adjacent hair units and leave a random pattern at the same time. Something that as the need for high numbers increases makes it impossible to maintain a random pattern and allowing for missing adjacent hair units to avoid larger gaps between each punch.

High or average hair density donor areas it almost doesn ´t matter as the pattern of extraction still needs to be monitored maintain a balance around the donor area. It ´s not wise to take a larger number from an area with a high hair density to match the areas of lower hair density as it doesn ´t work like that. Once healed there is an obvious demarcation line between the area harvested and the virgin scalp area.

By spreading the numbers over multiple procedures cares for the scalp and improves the number of grafts available over time as well as making it easier to respect a harvesting pattern to not remove too many in any specific area. It may not seem that important at the time and wanting to achieve the maximum number of grafts is more appealing but it can effect the quality of the donor area making any further work impossible.

 
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A

Aerospace

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#7
Some clinics are claiming very high numbers for available donor availability. It use to be somewhere in the region of 5000, up to 7500 for a lucky candidate. Nowadays, 8000 plus is quoted on a regular basis. Young guys in their early twenties having 5000 plus grafts, some in one sitting. An epidemic of bad results seem could be seen in the not so distant future.
 
Hair Restoration Europe

Hair Restoration Europe

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#8
Aerospace wrote:
Some clinics are claiming very high numbers for available donor availability. It use to be somewhere in the region of 5000, up to 7500 for a lucky candidate. Nowadays, 8000 plus is quoted on a regular basis. Young guys in their early twenties having 5000 plus grafts, some in one sitting. An epidemic of bad results seem could be seen in the not so distant future.
Recently I have seen three individuals post their results and their concerns of scarring from FUE. All had undergone large sessions, 4000 plus and all were around five to eight months post op, so a more than reasonable time to expect the donor area to have relaxed. As bad as each case was it was obvious each person never understood the consequences of taking so much or too much and certainly were not warned, probably the opposite and the focus was on the high graft numbers they would receive.
 
Bigmac

Bigmac

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#9
I hope more people researching read posts like this. Nice additional part two.
 
Felixe

Felixe

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#11
What are safe transplanted density levels and do they differ on certain parts of the scalp?
 
Hair Restoration Europe

Hair Restoration Europe

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#12
What are safe transplanted density levels and do they differ on certain parts of the scalp?
It´s not a simple question to answer specifically as there are so many variables to consider. Safe transplant density levels generally will be that ensures a high survival rate of the transplanted graft and does not affect negatively any surrounding grafts or existing hair. The natural hair characteristics of the person will be a factor in how close each graft needs to be placed as will the hair colour compared to the skin complexion. Also, the technique or method used to make the recipient sites in the first place as this will impact on the style of placement. The area of the scalp will differ in hair density required for example the hairline with single hair units closer together compared to multiple hair units being able to spread further apart at a lower density. Of course, the skill of the practitioner creating the slits and the individual placing the grafts has a great deal to play in the result and how close each graft can safely be placed and result in a high survival rate.